Background: Guillain Barre Syndrome (GBS) and Miller Fisher Syndrome (MFS) are emerging as known consequences of COVID-19 infection. However, there have been no reported cases with positive GM1 or GQ1b antibodies in the literature to date. Although clinically similar, the pathophysiology of COVID-19 related GBS and MFS may be significantly different from cases in the pre-pandemic era.
Case presentation: We present a patient with ascending areflexic weakness consistent with GBS with positive GM1 antibody. The patient had recovered from COVID-19 infection two weeks prior with mild viral illness and symptoms. Her weakness was isolated to the lower extremities and improved after intravenous immunoglobulin treatment. Patient recovered eventually.
Conclusions: - The general lack of reported ganglioside antibodies supports a novel target(s) for molecular mimicry as the underlying etiology, which raises the concern for possible vaccine induced complication. Whether the current GM1 positive case is a sequalae of COVID-19 or a mere coincidence is inconclusive. Further understanding of the disease mechanism of pandemic era GBS and MFS, including antigen target(s) of COVID-19, may be of utmost importance to the development of a safe COVID-19 vaccine.
Keywords: ACE2, Angiotensin-Converting Enzyme 2; COVID-19; GBS, Guillain Barre Syndrome; GM1; Guillain barre syndrome; HSP, Heat Shock Protein; MFS, Miller Fisher Syndrome.
© 2021 The Author(s).